| NPI | 1891859500 |
|---|---|
| Former Legal Business Name | THIBODAUX INJURY & REHABILITATION |
| Entity Type | Organization |
| Authorized Contact | BEAU I. PORCHE Owner 985-873-8586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1380) |
| Additional Taxonomies | 111NR0400X (Licence: LA 1380) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2016-04-12 |